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Archives of Orthopaedic and Trauma Surgery

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04-09-2023 | Dupuytren Disease | Handsurgery

Collagenase clostridium histolyticum injection versus limited fasciectomy for the treatment of Dupuytren’s disease: a systematic review and meta-analysis of comparative studies

Authors: Rémy Liechti, Dominique Nellie Merky, Damian Sutter, Ramin Ipaktchi, Esther Vögelin

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2024

Abstract

Introduction

The aim of the present study is to systematically review the literature on well-selected comparative studies for meta-analysis on outcome differences between collagenase clostridium histolyticum (CCH) injection and limited fasciectomy (LF) for Dupuytren’s disease.

Materials and methods

PubMed/Medline, Embase, and the Cochrane Library were searched for comparative studies assessing differences in outcomes of CCH and LF. Effect estimates were pooled across studies using random effects models and presented as weighted mean difference (MD) and odds ratio (OR) with corresponding 95% confidence interval (CI).

Results

A total of 11 studies encompassing 1′051 patients was included (619 patients in the CCH and 432 in the LF group). The residual contracture at a minimal average follow-up of three months was higher in the CCH group than in the LF group (27.8 vs. 16.2°, MD 11.6°, 95% CI [8.7, 14.5°], p < 0.001). The recurrence rate was significantly higher in the CCH group (25.8 vs. 9.3%, OR 5.2, 95% CI [1.5, 18.8], p = 0.01) while the rate of severe complications was significantly higher in the LF group (0.3 vs. 7.3%, OR 0.12, 95% CI [0.03, 0.42], p = 0.001).

Conclusions

Evidence of the present study confirms that CCH injection has a higher rate of disease recurrence whereas LF carries a higher risk for severe complications. It’s imperative that the trade-off between these aspects is considered, keeping in mind that CCH injections may be repeated in case of disease recurrence without increasing procedure related risks, especially in complex cases.

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Title: Collagenase clostridium histolyticum injection versus limited fasciectomy for the treatment of Dupuytren’s disease: a systematic review and meta-analysis of comparative studies
Authors: Rémy Liechti
Dominique Nellie Merky
Damian Sutter
Ramin Ipaktchi
Esther Vögelin
Publication date: 04-09-2023
Publisher: Springer Berlin Heidelberg
Keywords: Dupuytren Disease
Clostridium
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2024
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-05004-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Collagenase clostridium histolyticum injection versus limited fasciectomy for the treatment of Dupuytren’s disease: a systematic review and meta-analysis of comparative studies

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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